一组早产儿中的动脉导管未闭和自发性肠穿孔
Patent ductus arteriosus and spontaneous intestinal perforation in a cohort of preterm infants.
作者信息
Mayer Alessandra, Francescato Gaia, Pesenti Nicola, Schena Federico, Mosca Fabio
机构信息
NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy.
出版信息
J Perinatol. 2022 Dec;42(12):1649-1653. doi: 10.1038/s41372-022-01403-8. Epub 2022 May 19.
OBJECTIVE
To assess whether either duration and magnitude of ductal shunt or medical treatment for patent ductus arteriosus (PDA) are related to spontaneous intestinal perforation (SIP).
STUDY DESIGN
Clinical charts of infants <29 weeks' gestation born from 2006 to 2018 were reviewed. Echocardiographic examinations were evaluated according to McNamara and Sehgal's staging system.
RESULTS
A higher percentage of patients with SIP had a hemodynamically significant PDA (HSPDA) and was treated with either NSAIDs or paracetamol (79% vs 53% and 81% vs 54%, respectively). Among non-treated patients, we found a 1.32 increase in the odds of SIP per day of persistence of HSPDA. In the cohort of patients treated despite the absence of HSPDA, we found a 2.35 increase in the odds of SIP per dose of drug administered.
CONCLUSION
Both treating a non-HSPDA and leaving a HSPDA to its natural history seem to be associated with SIP.
目的
评估动脉导管分流的持续时间和程度或动脉导管未闭（PDA）的药物治疗是否与自发性肠穿孔（SIP）相关。
研究设计
回顾了2006年至2018年出生的孕周小于29周的婴儿的临床病历。根据麦克纳马拉和塞加尔的分期系统对超声心动图检查进行评估。
结果
患有SIP的患者中，血流动力学显著的PDA（HSPDA）比例更高，且接受了非甾体抗炎药或对乙酰氨基酚治疗（分别为79%对53%和81%对54%）。在未治疗的患者中，我们发现HSPDA持续存在的每一天，SIP的发生几率增加1.32。在尽管不存在HSPDA但仍接受治疗的患者队列中，我们发现每给药一剂，SIP的发生几率增加2.35。
结论
治疗非HSPDA和任由HSPDA自然发展似乎都与SIP有关。
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